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General Surgery · Hernias
Sample itemWhat distinguishes a strangulated hernia from a reducible uncomplicated hernia?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Compromised blood supply to herniated contents
A strangulated hernia traps tissue tightly enough to impair venous and arterial flow, creating escalating pain, obstruction, and risk of bowel necrosis, so it requires urgent surgical evaluation.
Option by option
A. Compromised blood supply to herniated contents (correct)
Correct: vascular compromise is the defining danger of strangulation.
B. Normal bowel sounds in every case
Bowel sounds vary and cannot exclude a strangulated hernia.
C. A scar elsewhere on the abdomen
An unrelated abdominal scar does not establish hernia strangulation.
D. Presence of any cough impulse
A cough impulse may be absent in incarceration but does not define ischemia.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.